Clinical change during inter-hospital transfer for thrombectomy: Incidence, associated factors, and relationship with outcome Article Swipe
Pierre Seners
,
Adrien ter Schiphorst
,
Anke Wouters
,
Nicole Yuen
,
Michael Mlynash
,
Caroline Arquizan
,
Jeremy J. Heit
,
Stephanie Kemp
,
Sören Christensen
,
Denis Sablot
,
Anne Wacongne
,
Thibault Lalu
,
Vincent Costalat
,
Gregory W. Albers
,
Maarten G. Lansberg
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1177/17474930241246952
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1177/17474930241246952
Background: Patients with acute ischemic stroke with a large vessel occlusion (LVO) admitted to non endovascular-capable centers often require inter-hospital transfer for thrombectomy. We aimed to describe the incidence of substantial clinical change during transfer, the factors associated with clinical change, and its relationship with 3-month outcome. Methods: We analyzed data from two cohorts of acute stroke patients transferred for thrombectomy to a comprehensive center (Stanford, USA, November 2019 to January 2023; Montpellier, France, January 2015 to January 2017), regardless of whether thrombectomy was eventually attempted. Patients were included if they had evidence of an LVO at the referring hospital and had a National Institute of Health Stroke Scale (NIHSS) score documented before and immediately after transfer. Inter-hospital clinical change was categorized as improvement (⩾4 points and ⩾25% decrease between the NIHSS score in the referring hospital and upon comprehensive center arrival), deterioration (⩾4 points and ⩾25% increase), or stability (neither improvement nor deterioration). The stable group was considered as the reference and was compared to the improvement or deterioration groups separately. Results: A total of 504 patients were included, of whom 22% experienced inter-hospital improvement, 14% deterioration, and 64% were stable. Pre-transfer variables independently associated with clinical improvement were intravenous thrombolysis use, more distal occlusions, and lower serum glucose; variables associated with deterioration included more proximal occlusions and higher serum glucose. On post-transfer imaging, clinical improvement was associated with arterial recanalization and smaller infarct growth and deterioration with larger infarct growth. As compared to stable patients, those with clinical improvement had better 3-month functional outcome (adjusted common odds ratio (cOR) = 2.43; 95% confidence interval (CI) = 1.59–3.71; p < 0.001), while those with deterioration had worse outcome (adjusted cOR = 0.60; 95% CI = 0.37–0.98; p = 0.044). Conclusion: Substantial inter-hospital clinical changes are frequently observed in LVO-related ischemic strokes, with significant impact on functional outcome. There is a need to develop treatments that improves the clinical status during transfer. Data access statement: The data that support the findings of this study are available upon reasonable request.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1177/17474930241246952
- OA Status
- green
- Cited By
- 5
- References
- 20
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4393986614
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4393986614Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1177/17474930241246952Digital Object Identifier
- Title
-
Clinical change during inter-hospital transfer for thrombectomy: Incidence, associated factors, and relationship with outcomeWork title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-04-05Full publication date if available
- Authors
-
Pierre Seners, Adrien ter Schiphorst, Anke Wouters, Nicole Yuen, Michael Mlynash, Caroline Arquizan, Jeremy J. Heit, Stephanie Kemp, Sören Christensen, Denis Sablot, Anne Wacongne, Thibault Lalu, Vincent Costalat, Gregory W. Albers, Maarten G. LansbergList of authors in order
- Landing page
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https://doi.org/10.1177/17474930241246952Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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greenOpen access status per OpenAlex
- OA URL
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https://inserm.hal.science/inserm-05139081Direct OA link when available
- Concepts
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Medicine, Incidence (geometry), Outcome (game theory), Intensive care medicine, Pediatrics, Emergency medicine, Optics, Mathematics, Mathematical economics, PhysicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
5Total citation count in OpenAlex
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2025: 4, 2024: 1Per-year citation counts (last 5 years)
- References (count)
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20Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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